Hi Dr Young,
First I would like to thank you for your immediate response early this year when I needed advise about efavirenz and Lamzid prescribed for my partner. He is tolerating the drugs ok so far.

We just have a concern, he has developed rash on his arms and legs and that does not seem to go even with anti-allergic lotions. Initially we thought its just a skin reaction as he usually gets that in summer. Lately it seems seems to be spreading to the body as well (never before), although it has not manifested like it is on the arms and legs. Where it seems to be healing,the sores leaves ugly dark patches, don't even know whether its even right calling it a rash. Could this be a side-effect of bactrim and would he require a switch? Someone suggested dapsone as an alternative, but I read about the side effects it might have and we're a bit hesitant. When he started on meds in Jan the cd4 count was 100, so he still needs bactrim as his cd4 is still low.

Your advise is always appreciated.

Candy, SA

Response from Dr. Young

Dear Sandy SA,

Thanks for your comments and follow up.

It is good to hear that your friend is doing well on the efavirenz and Lamzid (AZT+3TC).

A rash that is limited to the arms and legs isn't one that I'd call a generalized drug reaction (as would usually be the case with a sulfa allergy). On the other hand, this anatomic distribution is highly suggestive of a sun-related reaction with the sulfa, a not uncommon event.

Avoiding sun exposure to the arms and legs (either with clothing or sunscreen) often helps this.

As for dapsone, if the above strategy doesn't help, a switch could be in order. We find the medication to be quite well tolerated and FWIW, you are correct that your friend does need to continue on medication to prevent PCP.

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

The Body is a service of Remedy Health Media, LLC, 750 3rd Avenue, 6th Floor, New York, NY 10017. The Body and its logos are trademarks of Remedy Health Media, LLC, and its subsidiaries, which owns the copyright of The Body's homepage, topic pages, page designs and HTML code. General Disclaimer: The Body is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through The Body should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.